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NPI Code Detail

MEDICARE: DR. KRYSTAL JANE MCNUTT PSYD

MEDICARE: DR. KRYSTAL JANE MCNUTT PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY.0006336CO

General Provider Information

NPI Number : 1255948089
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRYSTAL JANE MCNUTT PSYD
Provider Business Mailing Address
First Line : 26010 OAK RIDGE DR STE 107
Second Line :
City : THE WOODLANDS
State : TX
Zip : 77380-1972
Country : US
Telephone Number : 281-815-0899
Fax Number : 281-528-1107
Provider Business Practice Location Address
First Line : 5353 N UNION BLVD STE 202
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-2069
Country : US
Telephone Number : 970-806-3225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2020
Last Update Date : 01/09/2026

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